Frequent Physical Distress in United States

United States

Frequent physical distress aims to capture the population experiencing persistent and likely severe physical health problems, which can significantly impact health-related quality of life and overall wellness. It is measured by asking survey respondents how many days they experienced poor physical health in the past month and quantifying those who report 14 or more physically unhealthy days. The Centers for Disease Control and Prevention validated the cutoff point of 14 days as constituting a substantial level of physical impairment.

Frequent physical distress is associated with behavioral and metabolic factors such as smoking, physical inactivity and obesity; limited health care access and lower use of preventive care services; and chronic health conditions such as diabetes, hypertension and chronic obstructive pulmonary disease. There is also a strong relationship between physical and mental distress. Low physical activity, chronic illness and physical disability are all correlated with higher rates of psychological distress.

According to America’s Health Rankings analysis, populations with a higher prevalence of frequent physical distress include:

• Women compared with men.
• Adults age 65 and older compared with those ages 18-44.
• American Indian/Alaska Native and multiracial adults compared with Asian adults. All racial/ethnic groups had a higher prevalence than Asian adults.
• Adults with less than a high school education than those with higher educational attainment. The prevalence of frequent physical distress significantly decreases with educational attainment.
• Adults with an annual household income less than $25,000 compared with those with higher incomes. The prevalence of frequent physical distress decreases with each increase in household income level.
• Adults who live in nonmetropolitan areas compared with those who live in metropolitan areas. 
• Adults who have difficulty with self-care compared with adults without a disability.
• Lesbian, gay, bisexual and queer (LGBQ+) adults compared with straight adults.
• Adults who have served in the U.S. armed forces compared with adults who have not served.

Strategies to reduce the prevalence of frequent physical distress include preventing or managing chronic conditions such as cardiovascular disease, cancer, diabetes, obesity and arthritis. Evidence-based interventions that help reduce chronic conditions include curbing smoking, increasing physical activity and promoting healthy eating.

Healthy People 2030 has an objective to reduce the proportion of adults with chronic pain that frequently limits life or work activities.

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Byles, Julie E., Ian Robinson, Emily Banks, Richard Gibson, Lucy Leigh, Bryan Rodgers, Cassie Curryer, and Louisa Jorm. “Psychological Distress and Comorbid Physical Conditions: Disease or Disability?” Depression and Anxiety 31, no. 6 (June 2014): 524–32. https://doi.org/10.1002/da.22162.

Centers for Disease Control and Prevention. “Strategies to Prevent Obesity and Other Chronic Diseases: The CDC Guide to Strategies to Increase the Consumption of Fruits and Vegetables.” Atlanta, GA: U.S. Department of Health and Human Services, 2011. https://stacks.cdc.gov/view/cdc/21639.

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Gamble, Sonya, Tebitha Mawokomatanda, Fang Xu, Pranesh P. Chowdhury, Carol Pierannunzi, David Flegel, William Garvin, and Machell Town. “Surveillance for Certain Health Behaviors and Conditions Among States and Selected Local Areas — Behavioral Risk Factor Surveillance System, United States, 2013 and 2014.” MMWR. Surveillance Summaries 66, no. 16 (September 15, 2017): 1–144. https://doi.org/10.15585/mmwr.ss6616a1.

Stellefson, Michael, Samantha R. Paige, Adam E. Barry, Min Qi Wang, and Avery Apperson. “Risk Factors Associated with Physical and Mental Distress in People Who Report a COPD Diagnosis: Latent Class Analysis of 2016 Behavioral Risk Factor Surveillance System Data.” International Journal of Chronic Obstructive Pulmonary Disease 14 (April 2019): 809–22. https://doi.org/10.2147/COPD.S194018.